21 December 2023

Comment: When will we see the government’s values of ‘community, equality and opportunity’ reflected in investment in social care?

Our CEO Rachel Cackett responds to publication of the 2024-25 Budget

Responding to Tuesday’s announcement of the 2024-25 Budget, Rachel Cackett, CEO of CCPS, said:

“It’s very disappointing to see the social care sector overlooked, under-discussed and lacking in committed investment.

The government says public services need reform to be sustainable, particularly the NHS.

Government needs not-for-profit social care providers to deliver more prevention and early intervention for that to happen.

But to do that, providers need to still be here and to be sustainable.

Announcements yesterday reiterated that the base rate of pay would increase to £12 per hour for care and support staff starting in April 2024.

That means pay for our regulated, trained and largely female workforce will continue to remain unacceptably low in the context of rising living costs, a sector recruitment and retention crisis, and ever-growing demand for social care services.

This budget doesn’t address the current crisis in social care and doesn’t invest for the future.

Tougher budgets mean tougher decisions, but choice is what governs decision-making. And choices reflect the true values of the Scottish Government.

If the Scottish Government wants to be true to its words on ‘community, equality and opportunity’, we must see those values reflected in investment in our sector.

But this isn’t over: there is still time invest in the future of Scotland.

We are calling on the Scottish Government to Rethink To £13 per hour, at least, for social care and support staff as a first step in a timetable to equity.”

CCPS is currently analysing the full budget to assess the real terms impact of the announcement on social care spending across government portfolios.

Resources:

Link to our Rethink To 13 campaign

Link to Scottish Budget

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19 September 2023

4 Steps Guest Blog: “Our staff deserve recognition for their drive, passion and commitment”

Immediate action and appropriate funding is needed to ensure children’s social care services can deliver for their workforce as they deliver for Scotland’s children, argues Capability Scotland’s Ben Bradbury

Capability Scotland work with disabled children and their families across Edinburgh, Dundee, Lanarkshire and Renfrewshire in a range of settings including holiday support, community services and residential care. We are committed to delivering outstanding care, support, and opportunities for the young people we work with and key to that is our workforce.

By their nature services for school age children and young people tend to have unusual working patterns. With children attending school during the week the support we offer is, with the exception of school holiday provision, in the evening or at weekends. This presents challenges to recruitment and retention of staff as the hours required of staff to deliver this support do not always sit comfortably alongside raising their own families or maintaining a healthy work life balance. In addition, the qualification and experience levels expected of staff in these services is often higher than in their adult equivalents, for example our day care of children registered managers must be qualified to degree level. There are good reasons for this, indeed we often work with some of the most vulnerable individuals in society, but it adds to the challenge of maintaining appropriate staffing levels of the required skill and competency.

In spite of these challenges our children’s services staff are enthusiastic, creative, playful and without exception go above and beyond to deliver exceptional services for the young people in their care. Whether it be attending training sessions at weekends to fit in with delivery of holiday support or working late on an evening to enable a trip to the cinema to take place we ask a lot of our teams, and they rise to the challenge.

However, since the pandemic an additional challenge has presented itself for organisations such as ours. The pandemic rightfully shone a light on the pay levels for social care staff, the response from the Scottish Government and local authorities has focused entirely on adult social care staff. The government, through the various Health and Social Care Partnerships (HSCPs), has provided additional funds to raise the minimum rate of pay for staff in adult social care roles. These uplifts had the effect of keeping the minimum rate of pay for staff in adult services above the Scottish Living Wage throughout the pandemic and in line with the living wage in 2023.

Unfortunately, no such uplifts have been forthcoming for our children’s services. Unlike with adults, services for children and families tend to be commissioned by the local council rather than the HSCP. There has been no reciprocal offer from the Scottish Government for children’s services, the knock-on effect has been that many of our children’s services have had no universal uplift to the rates paid by local authorities during a period of high wage and price inflation. During this period Capability Scotland has met the cost of increasing wages for children’s service staff in line with their adult service counterparts. However, this state of affairs is not sustainable indefinitely.

If appropriate funding arrangements aren’t arrived at there will be negative consequences on our ability, and the ability of organisations like ours, to continue delivering high quality care and support for disabled children across Scotland. Much has been made of the need to support Fair Work practices across the public sector, as an employer we fully embrace this approach, and we believe our staff deserve recognition for their drive, passion and commitment. As an organisation we welcome the First Minister’s recent statement regarding an uplift to £12 an hour which appears to be inclusive of staff across both adult and children’s services. However, there remains much uncertainty about the timescales and mechanisms by which this will be delivered.

What is needed now is immediate action and appropriate funding to enable us to deliver for our staff as they deliver for Scotland’s children.

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11 September 2023

4 Steps Guest Blog: “On pay for social care staff, I see only despair and anger”

Last week the First Minister announced plans for a rise in baseline pay for social care staff to £12. Where does this leave supervisory staff – and who will recognise their skills? asks Stephen McLellan, Chief Executive of Recovery Across Mental Health

I want to refer to a couple of conversations I have had with colleagues recently to help put the context of developing a career in social care into some perspective.  I shall be retiring shortly, after 47 years in Health and Social Care, so I feel I have some background in this.

Few people will have heard of RAMH – Recovery Across Mental Health, as we are a local organisation, operating mainly in Renfrewshire, East Renfrewshire, North Ayrshire and Argyll and Bute. However, we probably reflect the reality of many third sector organisations in Scotland: local delivery by local people to meet local needs.

We employ around 180 staff, 50 volunteers and support over 5,000 people every year.

The first comment by a colleague pretty much sums up the description above:

“We just do it. We turn up and we don’t give up.’’

This very simple description defines what society requires from care, support and health workers. We expect services when and where we need them, no questions asked, because that’s the right thing to do, isn’t it?

To rhetorically answer my own question, yes it is. But how can we continue to expect this if we are not able to acknowledge the value of what we ask?

We expect people to work at the barest minimum rate of pay, with a token nod towards pensions. We put people in stressful, challenging and often demanding situations and offer them £10.90 an hour.  Colleagues who provide supervision and management are expected to do this at rates that are in relation to colleagues in health, paltry.

This takes me onto the conversation with another colleague, yesterday.  She has been offered and is taking a job as a Social Work Assistant, in a local authority. She doesn’t want to leave, but the increase in salary and the security of a pension leaves her little choice. As she explained, “You guys gave me training and experience that meant I was able to apply for this job. I feel awful, but I can’t turn down the money’’.

I will not disagree with colleagues in statutory organisations who argue for better terms and payment. Good luck to them. However, I cannot understand what value there is in governments not understanding that every time health colleagues receive an increase, it only widens the gap for social care staff, which in turn encourages more people to leave and discourages new entrants.

The First Minister recently announced the 2023-24 ‘Programme for Government’. He noted the potential for a baseline payment of £12 an hour, perhaps from April 2024? I refer back to my comments above: where does this leave supervisory staff? Who will recognise their skills and their needs?

There is no moral, or fiscal argument that justifies this myopic policy. It is purely a short term, transactional arrangement that is creating despair and anger across a huge swathe of the voting population.

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25 July 2023

4 Steps Guest Blog: “What is the ethical defence of unequal pay?”

Old concepts of moral principle, politics and logic help explain the absence of fair work in social care, says Ron Culley

Ethos, demos and logos were concepts used by the ancient Greeks to make sense of the world around them: ethos referred to the development of a moral principle or argument, rooted in human values; demos referred to the body politic, to the rules of self-government; and logos referred to reason and rationality, the logical flow of an argument.

Two-and-a-half-thousand years later, and it seems to me these concepts are still useful in making sense of the world around us. The principle of fair work in social care, and the limited political progress that we have made towards it, can be helpfully understood by applying these concepts.

Ethos

The ethical argument for fair work in social care is plainly put. If social care workers across different sectors are delivering similar taxpayer-funded public services, why should the level of pay be different? Given that care workers are providing work of equal value, is the Scottish Government justified in mandating that a Healthcare Assistant in the NHS be paid £14 per hour, a homecare worker in a council £16 per hour, a support worker in a not-for-profit social care provider £10.90 per hour, and a care worker in a private sector care home £10.90 per hour? All of these jobs are comparable in terms of skill and responsibility.

So is it fair that the Scottish Government and Local Authorities have decided in favour of unequal pay? And let’s consider the fact that most people working in the care sector are women and that, on average, women continue to receive lower pay than men. Is it right that the Scottish Government and Local Authorities have not gone further to correct this injustice? Were there to be a reprioritisation of political choices, tens of thousands of women could be taken out of a low wage job. In short, the ethical defence of unequal pay is very difficult to present.

Demos

To explain why this situation nonetheless persists, we need to understand Scottish politics. The reality – however much we might want to pretend otherwise – is that the NHS is politically more important to the Scottish Government than the social care sector. It’s why many arguments about investing more in social care are actually framed around alleviating pressure on the NHS, and not about supporting people to realise their rights as citizens or to give expression to their personal agency. By this argument, social care is only important because to get it wrong damages the NHS, and a struggling NHS is a vote loser.

The other way democratic politics plays into this is in the stewardship of the public finances. There simply isn’t a strong enough tax intake to fund the health and social care system that many people would like, so we have developed a system that supports the cheap outsourcing of public services to the third and independent sector (euphemistically referred to as ‘best value’). That would be fine if it were a level playing field and all providers (including monopolistic providers like NHS Boards and Councils) had to compete for business on the same terms. But that would risk violating one of the golden rules of Scottish politics, that public sector delivery is best (despite evidence that the third sector consistently delivers higher quality care and support).

Logos

The problem with all of this is that it contains flawed logic and makes for poor strategy. What happens if we pay public sector care workers significantly more than third or independent sector workers? The answer is there is a migration of talent and experience from one to the other. As a result, the third and independent sector is weakened, especially given that the labour market has been structurally imbalanced by Brexit and Covid.

How will providers in the third and independent sector respond? I doubt there will be a dramatic implosion – there’s too much market diversity for that to happen. Rather, what we’ll see is a gradual reduction in service delivery across the sector – less care delivered by less people. That in turn will generate more unmet need. And where will those people go? I would imagine social work, GPs and Emergency Departments. Only this time, there’ll be no-one else to turn to.

Ron Culley is CEO of Quarriers, a member of CCPS’s Board and Chair of our Committee on the National Care Service

Find out more about our 4 Steps to Fair Work campaign

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24 March 2023

Vison and priorities for social care: Humza Yousaf responds to our questions

One of the three candidates vying to be Scotland’s next First Minister has outlined his commitments.

Humza Yousaf, one of three candidates competing to be Scotland’s next First Minister and leader of the SNP, has responded to a letter sent by our CEO Rachel Cackett and Board chair Andrea Wood.

In the letter, sent on 7 March, the candidates were asked three questions:

  • Will you commit to our 4 Steps to Fair Work?
  • Will you commit to implement social care reform and meet with us, within your first month in post, to discuss constructive ideas for positive and urgent change?
  • How would you articulate your own vision for social care reform in Scotland?

In response Mr Yousaf, who has been Cabinet Secretary for Health and Social Care since 2021, said:

“Thank you for taking the time to contact me as a candidate in the SNP leadership contest and for your patience in waiting for a response.

Currently as Cabinet Secretary of Health and Social Care, the issues you raise are important to me and would continue to be so if elected as First Minister.

There are two key commitments I want to make in regards to the Health and Social Care sector.

We need to make sure that our staff are properly paid – not only to recruit staff but to retain them.

Secondly, we have some reform to do in our NHS which will see as many people as possible treated as close to home as possible, leaving our hospitals available for emergencies only. This means that investment in our Social Care sector is at the heart of NHS reform and for bettering the conditions of work for social care workers.

If we have social care that has the right workforce, that is working for people, then we can stop them from coming in the front door of hospitals or GP practices, but we can also work on stopping the exit block and see people getting out the doors of hospitals as soon as they are fit to do so and back into their community, keeping as close to home as possible.

Therefore, reforming health care and social care has to be at the heart of my leadership. That is why I am passionate about the idea of a National Care Service – although I recognise that current proposals will need amendments, via dialogue with Local Government, Trade Unions, and membership organisations to make sure it works for everyone.

The principle of the National Care Service, where we have fair pay for our social care workers, where we have national collective sectoral bargaining, and where we have ethical commissioning – these markers will solidify a national social care system that is worthy of the name.”

Our letter also argued that a legislative pause could be an opportunity for the new First Minister to look afresh at social care reform based on our model, and to drive forward Fair Work and sustainable funding.

Ash Regan and Kate Forbes have yet to respond.

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C&P: Commissioning for Outcomes

The Independent Review of Adult Social Care 2021 made recommendations for significant and transformational changes to the way that social care is commissioned and procured including recommending a move to ethical commissioning and a focus on achieving better outcomes for individuals.

The Independent Review of Adult Social Care 2021 made recommendations for significant and transformational changes to the way that social care is commissioned and procured including recommending a move to ethical commissioning and a focus on achieving better outcomes for individuals: ‘We want to see an end to an emphasis on price and competition and to see the establishment of a more collaborative, participative and ethical commissioning framework for social care services and supports, squarely focused on achieving better outcomes for people using these services and improving the experience of the staff delivering them. By shifting emphasis in this way, we believe Scotland can deliver social care supports more fairly and more sustainably.’

In response to the recommendations, CCPS set up a Commissioning for Outcomes Project of local authority commissioners, providers and disabled people to develop a practical guide to Commissioning for Outcomes

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